PT  - JOURNAL ARTICLE
AU  - Marjorie A. Bowman
AU  - Anne Victoria Neale
TI  - Change, Lack of Change, and Creating Optimal Change Out of Chaos
AID  - 10.3122/jabfm.2011.06.110264
DP  - 2011 Nov 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 625--627
VI  - 24
IP  - 6
4099  - http://www.jabfm.org/content/24/6/625.short
4100  - http://www.jabfm.org/content/24/6/625.full
SO  - J Am Board Fam Med2011 Nov 01; 24
AB  - Once again, we consider how to effect practice change at the local and national levels. This issue includes several articles that relate to quality improvement. Some physician actions seem resistant to change, as do the underlying social determinants and processes that lead to what are thought to be avoidable hospitalizations, but we also find that concerted effort, along with standardized orders sets and other avenues, can make a difference. Sometimes, however, our attempts at change can lead to more distraction then efficacy. Here we include articles that place the quality issues in context, report interventions, and advance the types of specific knowledge that allow interventional trials. We also have several articles about cancer screening and follow-up, a subset of quality improvement.